Formal didactic instruction occurs on Tuesday afternoons from 1-5 pm. Weekly Grand
Rounds features presenters from local, regional, and national pools as well as senior
residents' presentations which are part of the graduation requirement. Residents meet
weekly for Resident Council. Every fall residents take the PRITE (Psychiatry Resident
in Training Examination). Their scores compare with local and national peeer scores
to identify strengths and weaknesses that can be addressed. CSE (Clinical Skills Exams)
occur in the second, third, and fourth years to assess resident progress and provide
regular feedback.

PGY 1 and 2 years have a one hour weekly case conference. PGY 3 and 4 years have one
hour a month available for scholarly project preparation as well as board review.
Residents are invited to attend a weekly lunch research meeting of the Department
of Psychiatry, and they are encouraged to participate.

PGY 1

Orientation curriculum starts a week before July 1 to prepare incoming interns for
their year of rotations. The PGY 1 year emphasizes interviewing, diagnostic and prescribing
skills, which expand as the residents move through their rotations in emergency psychiatry,
inpatient psychiatry, inpatient internal medicine, and neurology rotations. There
is an additional experience with outpatient primary care. By the end of the year residents
will be competent to manage crises and medically complex psychiatric patients. Residents
are expected to pass their Step 3 during the PGY 1 year.

Sample PGY I Rotation Schedule:

July

InpatientPsychiatry

Aug.

InpatientNeurology

Sept.

InpatientPsychiatry

Oct.

InpatientInternal Medicine

Nov.

VAMC EmergencyPsychiatry

Dec.

Inpatient Neurology

Jan.

InpatientPsychiatry

Feb.

InpatientInternal Medicine

Mar.

Outpatient Primary Care

Apr.

VAMC EmergencyPsychiatry

May

Outpatient Primary Care

June

InpatientPsychiatry

PGY 2

This year builds on fundamentals with introduction to supportive psychotherapy as
well as child psychiatry, consultation- liaison psychiatry, and inpatient psychiatry
which correlates with the primary rotations in this year. Residents develop more complex
inpatient care plans and informally mentor first year residents on these units, as
well as doing night float call coverage.

Sample PGY II Rotation Schedule:

July

InpatientPsychiatry

Aug.

2 weeks Consult/Liaison Psychiatry 2 weeks Night Float

Sept.

InpatientPsychiatry

Oct.

Child Inpatient Psychiatry

Nov.

InpatientPsychiatry

Dec.

2 weeks Night Float2 weeks Consult/Liaison Psychiatry

Jan.

Child InpatientPsychiatry

Feb.

2 weeks Night Float2 weeks Consult/LiaisonPsychiatry

Mar.

2 weeks Night Float2 weeks Consult/LiaisonPsychiatry

Apr.

Inpatient GeriatricPsychiatry

May

Consult/LiaisonPsychiatry

June

InpatientPsychiatry

PGY 3

The 3rd year of residency has a strong emphasis on more advanced psychotherapy learning
and individual therapy supervision utilizing direct interview sessions or review
of videotaped sessions of the resident's cases with experiences with supportive, cognitive-behavioral,
and psychodynamic therapies. Advanced psychopathology, and psychopharmacology including
substance abuse is also presented this year. Rotations in a number of outpatient clinics
give the residents opportunity for a more independent role in diverse patient exposure
and supervision.Also, didactic time is available to work on grand rounds or a scholarly
project.

Sample PGY III Rotation Schedule> July-June Outpatient Clinics:

Mondaya.m.

Psychotherapy

Tuesdaya.m.

Outpatient ChildClinic

Wednesdaya.m.

Adult Outpatient University PsychiatryClinic

Thursdaya.m.

Student CounselingClinic

Fridaya.m.

VAMC Adult OutpatientTele-Psychiatry Clinic

Mondayp.m.

VAMC MentalHealth Clinic

Tuesdayp.m.

Didactics

Wednesdayp.m.

VAMC Substance Use Clinic

Thursdayp.m.

University HealthClinic

Fridayp.m.

PsychopharmacologyBuprenorphineClinic

Note: All residents will do Adult Outpatient Psychiatry (University and Veterans Affairs
Medical Center), Substance Use Disorder, outpatient child/adolescent clinic and Psychotherapy
clinic as well as one of the outpatient specialty clinics.

PGY 4

The final year curriculum focuses more on resident consolidation of prior learning
with more senior roles in inpatient and C/L roles helping to mentor junior residents.
Six months of electives round out the curriculum with the residents' particular interests
helping direct sub-specialization or work choices. Past electives have been Hospital
Psychopharmacology, Veterans Clinical Living Center Consultation, Tele-psychiatry,
Women's Health, PTSD, Emergency Psychiatry, Consultation-Liaison Psychiatry, ECT,
Transcranial Magnetic Stimulation, Group Psychotherapy, Hypnosis, Resident as Teacher,
Substance Abuse, Pain Management, and Research. Residents are encouraged to develop
new electives that suit their interests. Psychiatry and Neurology Board Review course,
Transition to Practice, and continuation of clinical psychotherapy supervision in
a group format prepares the resident for future board certification and employment.

We offer residents a diversity of experiences with our various sites in a university
town that services a large patient catchment area including rural areas of Tennessee.

1) East Tennessee State University & Quillen College of Medicine

ETSU Psychiatry Building - Residents have outpatient general adult and psychotherapy clinics as well as didactics
at this site, which is housed on the campus of the Veterans Administration Medical
Center (VAMC). Residents also have the opportunity to be involved with Tele-psychiatry
and TMS at this site.

Student Counseling Center - University students can receive psychotherapy from a variety of counselors at this
location. Psychiatry residents provide supervised psychiatric medication services
here.

University Health Center - This is a general medical clinic through the Nursing department for university
students where faculty and psychiatry residents provide medication management.

Family Medicine Clinics - Residents have outpatient primary care experience in one or more of the three nearby
family medicine clinics as part of a team with family medicine residents and medical
students.

Innovation Lab - Residents have the opportunity to be involved with research at this site.

2) Veterans Administration Medical Center (VAMC)

The James H. Quillen Mountain Home VA Medical Center services the 41 county area of
Tennessee, Virginia, and Kentucky. Psychiatry training experiences here include adult
inpatient, outpatient, substance use, Consultation-Liaison, PTSD, Community Living
Center (geriatrics), ER, Tele-psychiatry, CBT psychotherapy, and ECT. Residents work
in interdisciplinary teams including consultive roles. The VAMC is a comprehensive
care hospital offering medical, psychiatric, and surgical services for residents.

3) Woodridge Hospital

A free standing 84 bed psychiatric private hospital affiliated with and across the
street from Johnson City Medical Center that offers child and adult inpatient, intensive
outpatient, and crisis services. Residents do several inpatient adult and child psychiatry
ward months at this location.

4) Neurology (Inpatient)

Residents are on an inpatient service in a private community hospital, about 30
minutes from ETSU, for their two months of Neurology.

5) Johnson City Medical Center (JCMC)

This is a large regional tertiary referral center that has medical, surgical, women's,
and pediatric services. JCMC is an acute-care teaching hospital where psychiatry residents
receive two months of inpatient general internal medicine as part of their primary
care training.

6) Helen Ross McNabb Center

A full service center providing care to those with mental illness, addiction and social
challenges. Residents can receive child and adolescent residential and outpatient
experiences in this center, which is located about 45 minutes from ETSU.